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2090 Carnelian Lanes-3 ----.s ---? __. INSPECTIUN RECORD /CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 . '+ I y? I J ' s• .y +' 4.? ' i t f I ; "i !; ? ?1,! !., ;, c. ? SITE ADDRESS: APPLICANT: l c lll?i 1AN[ ? i t l i i G' i 1 1 { •. !. ? ? ? S . )? . ? ? F• .1. : ? ? r . ! ?? ? .? G'? ? R Yg PERMIT, SUBTYPE: TYPE OF WORK: r, f ,.A if? ' i;. 1. i i ? i 1; i,i k; F E•> #. A R,: 1' S fV {I RAM7l+i1, 1 PJ111 ? ? Permit Holder Date Telephone # PLUMBING H VAC inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AI R TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST ! FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan C1?5 '1 y-' 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 ca, `7 0 c) c) New Construclion Reauiremenls RamodeUReoair Reauiremenls Office Use Onlv 3 regislered sile surveys showing sq. ft of l04 sq. ft. of house; and all roofed areas 2 copies of plan Cert of Survey Recd _ Y_ N (20% maximum lot coverage allowed) 1 set of Energy Calculalions for heated addilbns Tree Pres PWn Recd Y N 2 copies af plan showing beam 8windowsizes; poured found design, etc. 1 site survey faradditions & decks Tree Pres Required Y _N lsetofEnergyCalculatlons Add'rtian-Indkafedon-sitesepficsystem On-sIteSeptlcSystem _Y _N 3 copies of Tree Preservatbn Plan A lat platted aher 711193 Rim Joist Dehail Options selecl'an sheet (buildings with 3 orless unAs) r Date ko / ?C>7> Construction Cost SiteAddress 2 U`_7(7 r& L,????'-J L? Unit/Ste# Description ot Work / N 57111L 64> 52?Lr Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 -k1 _ 2 Praperty Owner Telephone # ( ) ? l P f ? L 0 l CL Contractor , L. ` Address 13 City State lilAJ Zip 7? 3? 7 Telephone #(`j? COMPLETE THIS AREA ONLY IF Energy Code Category - Minnesota Rules 7670 Cateeorv 1 _ (J submission type) • Residential Ventilalion Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted A NEW BUILDING Minnesota Rules 7672 . New Energy Code Worksheet Submitted Have you previously consiructed a building in Eagan with a similar plan2 _ Y _ fee applies. Licensed Plumber Telephone #( Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( N If so, 25% plan review I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved pl in the case of wor hich requires a review and approval of pl s. ?Ni`.' d"!`L-//?) NI ? Applicant's Printed Name Signature 4 2005 ? - _-- FERMIT QITY-OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: P.I.N.: 10-16702-050-05 PERMIT TYPE: Permit Number: Date Issued: 2090 CARNELTAN LANE LOT: 5 BLOCK: 5 CEOAR GROVE #3 BUILDING 093475 09/25/98 DESCRIPTION: Re P Lp c E B u,i„i n:g,., P e r m i t T y p e B,t;ild?ng"Wl?a,rk Type C.ensus Ca, de f, ?. Y. Y,. _. . l.i?y.x32fl.A bd ' ?? YJ "A ,s,= - .? r., .r af.r` ?'. 't ?w SSDING 5F (MISC.) REPAIR 434 ALT. RESIDENTIAI ?s ? p ??[i1 ?? "r .., ._ ??il'`. . ".r REMARKS: FEESUMMARY: vflLuATxoN $5,e0e Base Fee $99,75 Surcharge _ $ 2.?p Total Fee $102.25 SFFFREY'?TA'fiE5 CONSTRUCTION116742008 2631LIC $C?HAJF?ER ,70HN I N.O. BOX 576 2090 CARNELIAN LANE NdRTH BRANCH MN 55056 EAGAN MN 55122 .(612) 574-2009 (651)454-8482 ? I hereby acknowledge that T have read th3s app5ication and 3tate tihat''the , ?n1`arma,tiqn iis qo.rrect ond ag r,,ee, to cdmpli?hr al.l, apF,L?;cable StatB af htn. Statutes and tity of Eagan,Ord3nances. ' APPLIGANT/PERMITEE SIGNATURE QSSUED BY: SIGNATU RE , . 1998 BUILDING New Construction Requirements PERMIT APPLICATION CITY OF EAC,"pN 3830 PII.OT KNOB RD - 55122 661-4675 ? 3 registered site surveys ? 2 copies of plans (inGude beam 8 window s¢es: poured fid. design; etc.) ? 1 energy calcuiations • 3 wpies of Vee preservation plan rf lot platted aRer 7/1/99 required: _ Yes _ No DATE: (q DESCRIPTION OF WORK: , * , r?I l Jlt?..s:r?.lw o'? STREET ADDRESS: ? 0,10 ? e(' ri c? l?4 ` L ? h (RESIDENTIAL) I I aa.a5 Re?, modeUReoair Reauirements u • 2 capies of plan ? 2 sita surveys (e#erior additions 8 decks) • 1 energy calculations for heated addRions O? CONSTRUCTION COST; ?d ? f LOT: BLOCK: SUBD./P.I.D. #: ?P?ti G Y O V`e ?-3 Name:? -?o ?? P6one #: PROPERTY Laet First OWNER i Street Address: ?ci r ne?' w<-- City ? °Ry Stare: Zip: Company:_,,?1"?e4 Phone#: b?4 ;?D?O CONTRACTOR (? p ' 3 f"'? ? ) l el G Qj Street Address: ro pa'S)? License # Ciry J" oS`t?j c,vy-" State: V'-? Zip: 6-'r,-DS b ARCHITECT/ ENGINEER Company: Phone #: Nazne: Registration #: Street Address: City State: Zip: Sewer 8 water licensed piumber (new consdvction onty): and lot change is requested once permit is issued. Penalty applies when address chan! I hereby acknowledge that I have read this applica6on and state that th4 information is correct and agree to comply with all applicat State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ? OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received - Yes - No - Not Required -- % , -l BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling ? 07 4-plex ? 03 SF Addition ? 08 8-plex ? 04 SF Porch 0 09 12-plex ? 05 SF Misc. ? 10 _-plex WORK TYPE ? 31 New O 33 Alterations ? 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of 5fories Length Depth APPROVALS Planning OFFICE USE ONLY ? 11 Apt./Lodging ? 16 Bpsement Finish ? 12 Multi RepaidRem. O 17 Swim Pool ? 13 Garage/Accessory ? 20 Public Facility ? 14 Fireplace ? 21 Miscellaneous ? 15 Deck ° 0 36 Move I ? 37 Demolition I Basement sq. ft. Main level sq. ft. sq.ft. sq. ft. sq. ft. sq.ft. Footprint sq. ft. Building Engineering MCNVS System i City Water Fire Sprinklered PRV Booster Pump ? Census Code. SAC Code Census Bldg I Census Unit Variance I Permit Fee q - -75? Surcharge Plan Review license MC/WS SAC City SAC Water Conn. Water Meter Acct. Depasit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies TotaL• l 0 "d - a IS- Valuation: $ % SAC SAC Units CITY OF EAGAN Addition Cedar Grove #3 Cedar Grove _Lat J Qlk 2090 Carnelian Lane 10 1 smte Eagan?MNII 55122 1n.dt-w ?'.u.onlim.ti ?e- 45 9 - 1424 Improvement Date Amount Annual Vears Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK ,ESEWERLATERAL n 1972 130 .00 2,1 2 WATERMAIN # WATER LATERAL 1972 WATER AREA ' STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 6UILDING PER. SAC PARK EAGAlV TOWNSHIP BUILDING PERMIT Ownex ....... ?. 1'ruc? -°--^..c-'----_....-----------_....._.. Addresa (Presenl) -...._?.`..:-?:_`..------------.. Builder ------?r.!_ ?1:r.??...s.A1................... °................. .-------- -- Address .............. DESCRIPTION N° 1397 Eagan Townsbip Town Hall Dafe ._......'r:??G4....................... Siories To Be Used Fos Fronf Depih Heighi Esi. CosS Permi! Fee Romarks v v LOCATION or 15 1 5 I r.(,. _i?, This permif does aot auYhorize the use of sireels, roads, aileys or sidewalks nor does it give the omner or his agenf the right to czeate aap siiuafion which is a nuisance or which presenSS a haaard lo the hea]!h, safeiy, eonvenienee and general welfare !o anpone in the commuaity. THIS PERMIT MUST BE PT ON THE PA£MISE WHILE THE WOAK IS IN PRO_G?RE*S., This is !o ceriifp, -----_----------_-.... haspezmissioa !o erect a__'..?p?..4-..?_uPOn !he above dascribed premise subjec! !o the provisions of the Building Ordiaaace foe ??aqan Township adopled April 11, 1955. // ? ............................... .................... Per ............ l6c:e?t"'--...... 6.'r---.. ??E? ................. Chairman of Tnwn SoaRl B Buildin Insp eelor EAGAN `COVO/N S H 1 P BUILDINC PERMIT Ownex ....._.' . ........ . .. ... . . Address (preseni).. .. Builder ............................................... _ ... ... ---... Address .... ........... _..----'------- ....--"------------ .._..---_.----- ._.....----' ? DESCRIPTION M 1060 Eagan Township Town Hall Dale '__.._....."......_..................... .. Sfories -- To Be Used For - Fron1 Dep1h -?--I---- Heighi? Esi. Cosi ' P rmif Fee Remarks /? }u''„'4. C?,?.?y• ?' ? --- - ------- or LOCATION or lraci ` -- q _ ro _ ,C3.E s , 3 - y i This permil 8oes o-It aufho?r'ue ?he use ot slreeis, roads, alleys or sidewalks nor does it give the owner or his agent the :ighf !o create any siluaiion which is a nuisence or which presenls a hazard !o the healih, safety, convenience and general weSfare fo anpone in the eommunify. THIS PEAMIT MIIST BE KEPT ON THE PAEMISE WFiILE THE WORK IS IN PROGRE55. , This is !o eerlifY, ---- _._.......... has permission io ereet a...,'/q.... '? -''k•?j'. ._..........upon the above described premise subjeef to the provisions of the Buiidinq Ordinance for Eagan Td4,nship ad'6ptr.d April 11, 1955. .-?y} /?/? .? ?aC. ,,y ??' p / .......... ..... _.......'?.G4.Gt?L[--'??-.'-.?,?.:r.?.'..._._...._._. Pex _....---..__4'?-?E^ ,/'?^'??1?? f?l, ... ....... ....... . ? .... .. ........2 : Chaiiman of Tnwn Boerd ? Building Inspecior Q?.fi• This reqaest void f Lj r 7) ?Bmol ?rr54?" . -, Ls, gs? cT-- ck o.c- & CV,o? ? ?(f'- 33(15C„ Coc ao Req ue t D ?ry? 1?-?-CS`L Fre No. Fouph-?ilnsUecUOn Re4???red> [''?ReaAY Nuw Q Will Nu1dy Insoec- Gy?,G ror When fleady ? Liy(e?sed Electncal Conlractor I hereby requnst inspecM1On of ebova ? Owner electncal work installed ar Stree[ Adtlress, eox or Route No. Citv 2020 Carnelian Ln. Eagan ecLOn o. Townshi0 Npme or Na. Ran9e No. Coumy Dakota Occupani (PRINT) Pho?e o. ? David Aloane -3993 ?5 Power SuoVlier Adtlress Elacvical Cnmractor ICOmpany Name) Co r?!rnnt2rs l6cense Nn. . Rossow, Inc, µVo MaJing Address (CoMrnctor or Owner Making Instailauon) P.O, Box 254 Lake Elmo, Mn. 55042 Auth e ipnawre (ConVactor/Owner Making InstallatLun) Phone Number 770-so46 MIryIIESOTp STATE BOAHD OF ELECTflIC1TY - ' THIS INSPECTION NEpUEST WILL NOT GriB9s-Midwey Blde. - Aoom N-191 BE ACCEPTED 8V TFIE STATE BOARO 1827 UnoversitV Ave., St. Paul. MN 55104 , UNLESS PNOPER INSPECTION FEE IS o1.....e 19171 147_111, ENCLOSED. REQ.?EST FOR ELECTRICAL INSPECTION w-, EB-OO007-Oi Sae i?tructfons for camplflUng this form on back ot yellow cupy. T 7654? " X" Below Wqrk Covered by Thrs Requesl ' ?j 3 4 S(o Ne% Add Rep. Type ot Bmldinp AOPlfancas Wiretl Equipmant Wired }C Home Range Temporary Service Duplex Water Heater Liyhtin Fixtures Apt. Bwidin,y Dryer Electric Heatin Commercial Bldy. Fumace Silo Unloader Industrial Bldg. Air CondiLOner Bidk Milk Tank F2rm Other pev v Othr.r ISUentyl thnr SGCwfy Othcr Othpr Compute lnspecbon fee Below p Fee ServiceEnhenceSiEe a Fee feeders/Subfexders N Fee Cvcuits 0 to 100 Am ps 0 to 30 Am s 0 to 30 Am s 1 at to 200 qmps 31 to 100 qmps 31 to 100 Am s Ahove 200 qmps Above 100_Am s Above 100_Am s Transtormers Remote Control Circ. Partial%Other Fee Signs Special InspecLOn 5 T Ren i?ks O FE ? w - Rough-in Dat r. ,, tha cel ? ? NA Inspectoq hereby Final ????P inspection,has been I X_ made. This re4uest void 1R --m? 1...e, Th;s d4.as w d 1 I 1 a o? ^ O 6 ? 5 - C5h4929 C, 5 , 8 - cz-& -X! AequeSt Date 1j fire No. Rough-in Insnec?.on HeQwred> OHeady Wow II Novfy InsPec- / // ?Ves ?NO ?or When qeady WILicensed Electrical Convxctor I hereby repuast inspaction o1 ebove Owner eloetr{cal work irmtal Sireet Address, eoz o oute No. • Cit p ? e ion o. Towns ,p Name or No. ' Ranpe No. County Otcupnnt (PBINT Phone No. 7?c7- Power S ? ? Atldress 6f 3? ' ? ? ?? a, ? • Q, , , . . - j? a? Ele al Co ha tor ICO pan Namel ?A Contractor's License No. Mailin0 Jress (Co ctor or Owner Making Instailatio 1 ? , Autnor ze SiBnatur Contra or Owne king InsWllation) Ph e Number MINNESOTA STATE BOARO OF ELECTPICITY TMIS INSPECTION NEQUEST WILL NOT ONqps-Mitlwey Bldq. - Room N•181 BE ACCEPTED BY THE STATE 60ARD 1827 Univereitv pvs..81. Paul. MN 65104 UNLESS PROPER INSPECTION FEE IS phnna1pl?l ta2 Man ENCLOSEO. REQUEST FUR ELECTRICAL INSPECTION ee-ooooi-oe 0 bea inatructions lor complatin0 thia form on beck of vellow eopy. C.ri d qp4A3Gk-?K'selow Work Covered by This Request ol Bu,IEinq Ik M Fee Service EntrenCe Sixe d ' Fea Feadars/Subteetlars N Fea Circuits ? 0 to200qm 5 0 to30Am s 0 tn30Am s A6ove 200 qm ? 37 to 100 qmps 31 to 100 An?m Swimmin Pool , Above 100_Am s Above 100_P.m s Transformers rn ation Booms Pertia6'Other F e l iS- V V / V S`l ?/ I 13 2 9 6 ' je-- g s= 3 ?-z ReQUest Date 4- Fve o Roughtin Inspeclion Requaretll Ves o ea0y Now p Will Notity Inspector When Featly'+ I hcensed contractor p owner hereby request inspection of above electrical work at. JoD Atlaress street Box or Roule No ? 9n CO-rY1e?i? L1'1• Qry ?a a-n Seclmn No TownsM1ip Name or No Range No Co I 10.? p,clPRIn 5 Phane No Power Sup0lier AtlOress EI Incal Comracto? ICOmp Name) Q? c- Gonlractor's License N. CF?o il9a Mahng qtltlress iCOnvacioi or Owner Making Instel tion) P?oo a.e fkt? S 1gnaWre vaclonOwner Mabng Installauon) ? ! 0 -3SSS" 116 MINNESOTA STAT BO ND ECTRICITY TNIS INSPECTION REpIJEST WILI NOT Grigga-Mitlway BI Room 3 BE AGCEPTED 6Y THE STATE BOARO 1821 University Ave. St Paul. MN SStpG UNLESS PqOPER INSPECTION FEE IS Phane (811) 642-0800 ENCLOSED ? REQUEST FOR ELECTRICAL INSPECTION ;°.yn??=`w ? ee-oooo,-oe ,. , op See insimctions lor compleling Ihis form on back of yellow copy SP 37 ? 'X" 8elow Work Covered by This Request "???:•??° A(-3,Z ^ 75 ew Add Rep. TypeofBwldmg AppliancesWired EquipmemWued Home Range Temporary Serwce Duplex Water Heater Eleciric Heating Apt. Building Dryer O[her (Specify) Comm.llntlustnal Furnace Farm Air Conditioner Other ?specdyl Con[aotor§ RemarNS ? Compute lnspechon Fee Below: p Olher Fee # ServiceEniranceSrze Fee # Qrcuits/Feeders Fee Swimming Pool 0[0 200 Amps 0 to 100 Amps Transiormers Above 200 _ Amps A6ove 100 _ Amps Signs inspecmrs use oniy TO7AL Irrigation Booms Special Inspection ? /? V?/ Alarm/Commumca0on THIS INSTALLATION MAY BE OR CONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Eledncal Inspecroc hereby RO°9n-?n oate certify that the above inspection has been made Dete OFFICE IlSE ONLY Tnis request voitl 18 montns Irom S 3 ° +" RESIDENTIAL BUILDING PERMIT APPLICATION CITY OP EAGAN ' 3830 PILOT KNOB RD, EACAN MN 55122 651-681-4675 New Construction Reauirements ' RemodaYReoair Reawrements • ;:egisterea ide surveys showmg sq. ft of ;ot, sq k. of house, anE all raofed areas • 2 capies of plan (20 a maximum lot coverage allowe0) I set of Energy Calculations for heate0 additions • ?.:ocies of plan shownig beam 3 window s¢es, poured fountl 7esign, elc . 1 sile survey for extenor additions 8 decks • t;zt ol Eneryy Calcuiations . indicate ?f hame ierveC by septic syslem for additwns . 7 copies of i ree Preservation Plan if lot platted after 711193 • Rim Joist Detail Opnons selecdon sheet (hldgs with 3 or less umis) DATE oGk VALUATION ?-- SITE ADDRESS TYPE OF WORI iULTI-FAMILYBLDG _Y _N PIREPLACE(S) _ 0 _ 1 _ 2 APPUCANT?"t2?\Y?1? lCrf??nG STREETADDRESS f?;ZOQ I1..3"]PSi CITYF??C\A _STATOI1v ZIP9?q'-n TELEPHONE #k950A(Y.35-9707?CELL PHO IE # FAX # V PROPERTY OWNER TELEPHONE # , ----------------------------- ------------------------------------------------------ ------------ COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINVF:SOT.1 RCI.GS 7670 C.A'PF.GOItYpt I N[IVNG50'fA LtCL1•:5 7672 submission rype) • Residential VenWatlon Category 1 Worksheet Su6mitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: ____ Plumbine sy's[cm includes: Mechanicol Contractor: Mcch:uuu.il scs[cm includrs: Sewer/Water Contractor: .air Condiuoniiilg ' I-[cat Rccoccn• Scstcm Fee: $90.00 ?In 112002 ---•--------------------------------------------------------------•----=---•-'--------- -------- I hereby acknowledge that I have read this application, state that the information is corre t, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan na ' ? Signature of Applicanf I OFFICE USE ONLY _ Water SoFtener 4Va[er Heater No. of I3aths Phone n _ Latim' Sprinkler No. of R.I. Baths Certificates of Survey Received _ Tree Preservation Plan Recerved _ Not Reqwred _ Updated 4/02 PERMIT# ??99-3 SOOE iiESIDEPTIlkI. PLUM$IA6 PE crrY oF EaeaLv 3830 Pnoz [uvos fu Eksstv, auu ssiEs 651-661-4675 Please complete for: single family dwellings, Wwnhomes and condos whei backflow preventer for irrigation system SITE ADDRESS: OCl OWNERNAME:: T? INSTALLER NAME: i ? \ V STREET ADDRESS: ?[ UCJ CITY: LQ-6aV1UQ. , ( ' i permits are required for p RT ? p M?? FEB 0 7 ?np7 I ?I iV ?50 L #: - io a (ARE) -6 9 ( EA CODE) TE:' ZIP: _ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00 includes $40.00 County fee I Note: Additional consultant fees may apply • MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING: _ Adding fixtures to lower levels or room additions, excluding water so eners and water heaters. $ 50.00 _ A6andonment of septic system. _ Water turnaround - ewsting dwelling unit (+ 5/8" meter if needed -$ 718) + Other: _ RPZ: new installation/repairlrebuild _ lawn irrigation system ? ReplacemenUadditional: _ water softener kater heater , $ 15.00 l State Surcharge l I $ .50 t l $ ? TO a I hereby acknowledge that I have read ihis epplication, slate thal the Informadon is covect, 8nd ag comply with all a is the applipnPs responsfbllity lo notify the property owner thatthe Cityof Eagan assumei no Ifa , I for any damages operational and malntenance activities to the tacilities consVUCted under tlhis permit widiir? Ciry ro lrjqht-of•way/,p RECEIPT DATE: : City of Eagan ordinances. It by the City during ifs normal 1/02 � Use BLUE or BLACK Ink r------------------� I For Office Use � � � Permit#:��� � � -I � Clty of �a��� � . 5 0 � Permit Fee: D., 3830 Pilot Knob Road I I Eagan MN 55122 � Date Received: t a����� I Phone: (651)675-5675 � ,n� � Fax: (651)675-5694 � Staff: ��`�� � I ' I 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: Name o} �����'l. [�.J�� Phone: �D�� ��q 2 ���D e e Address/City/Zip: ���'� C*��1J�C ��� �fJ� Applicant is: Owner � Contractor r Description of work: ��'���. "� �(� C LP. ' Q �`� Construction Cost: �'�i'��� Multi-Family Building:(Yes /No�) Company: �a�i 5,.?l)� C�LcrSs ��Ju'?�'`.�^�� Contact:��� �j-�7� _C�C d� ,Qa.. ;� Address: L�� ��a` �;. ,J� S'r � �� City: ��U°��� State: � l�" Zip: ���� Phone:�J5����NJ�--��( Email: ���_����f C License#:�,L ����� 0 Lead Certificate#: r"�fi� l � ° � u � " J If the project is exempt from lead certification, please explain why: (see Page 3 for additional information} COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: . .�.E. . „ - (?�- � . a s � � i:�� o ��' Q f �� � �� � �� . �. . . � , a ss - : e, : , ,. nc uaf ; :s CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in confo nce with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is n to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of pla . Exterior work authorized by a building permit issued in accordance with the Minnesota S e Building�`Code must be completed within 180 days of permit issuance. ,,�-~`" X_ �l�x .��s5� X ApplicanYs Printed Name ' ant's Signature Page 1 of 3 Use BLUE or BLACK Ink r———————— --------� I For Office Use � � I • � Permit#: � ��O I City of �a��� � �G- � � Permit Fee: � 3830 Pilot Knob Road j � Eagan MN 55122 � Date Received: I Phone: (651) 675-5675 � i � Staff: Fax: (651) 675-5694 �_________________� 2015 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: ���� `'/5 Site Address: ��,� �/"��-�.- � Tenant: Suite#: � � �.. � ; Name: Phone: E��tS� �t = Address/City/Zip: �� _ Name: C..�I��'1 ��i ,�'/��I��l�z License#: �'/� 06 3771 �.� ,s /� /� / ° ; Address: �,�<f IYC����fJ9i�� t���i,o City; �.c G�J _ -. .:� � : � � � ¢ �� ��''�� ��l�.. Phone: �'J�t�3�-S ` y��� � State: Zip: Contact: ��/� Email: ��.� /� ������ �� -���� � �y ��� � New i�`Replacement _Repair _Rebuild _Modify Space Work in R.O.W. ����� � fi j� � — — — g``��= c 4� Descri tion of work: ��_ ..�� _ �� . � p � � RESIDENTIAL � ' �f �� � '��� �; �-� �� _- �Water Heater - Water Softener - Lawn Irrigation(_RPZ/_PVB) �- � �Add Plumbing Fixtures�Main/�Lower Level) ,�i �,T� ����� t Septic System � - � �� � ;�"� �����r±�,,, Water Turnaround � � : New � � 3�b : Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge) $60.00 Lawn Irrigation(includes$5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic Sxstem Abandonment,Water Turnaround'`(includes$5.00 State Surcharge) "`Water Turnaround (add$200.00 if a 5/8"meter is required) $115.00 Septic System New($10.00 per as built)(includes County fee and$5.00 State Surcharge) TOTAL FEES $ CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in confoRnance ' the o inances and codes of the Gity of Eagan; that I understand this is not a permit, but only an application for a permi,and is not to art without permit; that the work will be in accordance with the approved plan in the case of work which requires a review and appr al of plans. X �(�t l�r �i�r� �lr �(� X Applicant' Printe am Applica ' i nature �. .. _ � . . _ _.� _.._. _ __ -__ .. ., : ., .__ _ � _ -. �k -^ F �Y` . ��... ; . T A. w � . � ,��. �- . ... - . a ��>" ,.. � �-�.` ° ;�, > .. . �8��`�R@�� � �8 � �'� � �'' �' "��� - � �.���.��.. ��� � � �.__ �. _.��__ �� ,. "__ , _ � . � �, Use BLUE or BLACK Ink For Office Use/ �CC_:::::' `7 q 75--9 ty ��� � //a 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone:(651)675-5675 buildinginspectionsacityofeagan.com Staff: 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Q1 Date: f U/ 1 1 Site Address: 2-15 q 0 Ca'-v' 1 t0‘...A, Unit#: Name: 3 M-'('1 Icer tt Phone: b LI l 2 - ' s! Resident/ Owner Address/City/Zip: 2,0610 Cot. Mt( i c.n la Ast Fn a,ir- 1 h Applicant is: Owner X Contractor Q.c� i ec C. - L s id.a 1,4 K6 t4- i1rr Type of Work Description of work: C v . `� Construction Cost: 17 6 0 c) Multi-Family Building:(Yes /No)1 ) Company: N 6- C0v"trGt.CON h e_ Contact: I CIM Aka. { ' l Contractor Address:,�teo "I AVC N Sit t O City: A-.N()KA r�� `1b32Cf6i13 ii State: Mi w •Zip: 5C;303 Phone: mail: `1 �i/lc(C61n* t0 IC.r✓ eses License#:j to b I 1�/) I Lead Certificate#: F 5 9 t1' -` 1 If the project is exempt from lead certification, please explain why: COMPLETE THIS AREA ONLY IF CONSTRUCTING ANEW BUILDING In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NOTE Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.cityofeaoan.com/subscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be i. .•nformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, an. ork i not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and app rival of pl.ns. x J \ Ma(SCA Applicant's Printed me Ap 'cant's Signature Page 1 of 3